Keely Jean Gray, LPN
Individual provider Active NPI Licensed Practical Nurse · Ravenden, AR
NPI 1538081997 · NPPES record last updated Jul 28, 2026
Key facts
- NPI
- 1538081997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- L059580 (AR)
- Practice address
- 745 Highway 90 N
Ravenden, AR 72459-9091 - Phone
- (870) 810-0370
- NPI assigned
- Jul 28, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L059580 | AR | Yes |
Addresses
Primary practice location
745 Highway 90 N
Ravenden, AR 72459-9091
Mailing address
745 Highway 90 N
Ravenden, AR 72459-9091
Phone (870) 810-0370
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.